1. Discuss characteristics of ‘polar’ leprosy lesions 2. Discuss ‘reac

1. Discuss characteristics of ‘polar’ leprosy lesions 2. Discuss ‘reactions in leprosy’ 3. Elaborate about ‘management of a case ofmultibacillary leprosy’ 4. Discuss anti retroviral treatment 5. Discuss ‘pathogenesis of early stphilis’ In 10 marks format for 3rd yr dermatology post graduate theory examination

Reading File

Finding Sources

Reading File

Finding Sources

Reading File

Finding Sources

Reading File

All five answers are complete. Here is a quick guide to what each answer covers:

Quick Summary of What's Covered:

Q1 - Polar Leprosy Lesions covers the immunological basis of polarity (TT vs. LL), skin lesion characteristics of both poles (number, borders, sensation, sweating), nerve involvement patterns, histological features (granulomas vs. Virchow cells), lepromin test findings, Lucio leprosy variant, and a comparison table.

Q2 - Reactions in Leprosy covers all three types (Type 1 reversal reaction, Type 2 ENL, Lucio phenomenon), immunopathological mechanisms (DTH/Th1 for Type 1, immune complex/Th2 for Type 2), clinical features distinguishing each, systemic complications of ENL (orchitis, iridocyclitis, glomerulonephritis, amyloidosis), and treatment protocols including thalidomide and prednisolone.

Q3 - Management of Multibacillary Leprosy covers WHO MDT regimen with exact doses (rifampicin 600 mg monthly, dapsone 100 mg daily, clofazimine 300 mg monthly + 50 mg daily), duration (12 months), mechanisms of action of each drug, pediatric doses, management of pregnancy/HIV co-infection/defaulters, reaction management, and disability prevention.

Q4 - Antiretroviral Treatment covers all 5 drug classes (NRTIs, NNRTIs, PIs, INSTIs, Entry inhibitors) with mechanisms, key drugs, trade names, side effects, the standard first-line regimen (DTG+3TC+TDF), pharmacokinetic boosting with ritonavir/cobicistat, and when to switch therapy.

Q5 - Pathogenesis of Early Syphilis covers the organism's properties, inoculation, adhesion via fibronectin-binding proteins, rapid pre-chancre dissemination, chancre formation via obliterative endarteritis, morphology of the hard chancre, secondary syphilis features (palmar-plantar rash, condylomata lata, systemic manifestations), immune evasion mechanisms, and serological markers.

6. Discuss clinical features and treatment modalities of anogenital warts 7. Write short notes on: a. Eye involvement in leprosy b. Histology of borderline leprosy 8. Write short notes on: a. Intermediate leprosy b. Mycobacterium leprae 9. Write short notes on: a. Genital herpes complicating pregnancy b. Non-treponemal serological test for syphilis 10. Write short notes on: a. Diagnosis of chlamydia trachomatis in men b. Classification of balanoposthitis In 10 marks format for 3rd yr dermatology post graduate theory examination

Finding Sources

Reading File

Finding Sources

Reading File

Finding Sources

All five questions are fully answered. Here is what each answer covers:

Quick Reference Summary:

Q6 - Anogenital Warts (10 marks): Etiology (HPV 6/11), epidemiology, morphological types (condyloma acuminata, papular, flat, keratotic, giant condyloma/Buschke-Löwenstein), sites in men and women, symptoms, special situations (pregnancy, HIV, children), diagnosis including acetowhitening and koilocytes, and full treatment table covering patient-applied (podophyllotoxin, imiquimod, sinecatechins) and provider-applied (cryotherapy, TCA, electrocautery, CO₂ laser, surgical excision) modalities plus HPV vaccination.

Q7a - Eye Involvement in Leprosy (5 marks): Three pathways (direct invasion, nerve damage, reactions), madarosis, lagophthalmos from facial nerve palsy, corneal anesthesia from trigeminal involvement, iridocyclitis in ENL, iris pearls (pathognomonic), pupillary miosis, corneal lepromata, secondary glaucoma/cataract, and management including tarsorrhaphy.

Q7b - Histology of Borderline Leprosy (5 marks): Systematic comparison of BT (well-formed granulomas, giant cells, no grenz zone, AFB 0-1+), BB (ill-formed granulomas, no giant cells, partial grenz zone, AFB 1-2+, onion-skin perineural), and BL (foamy macrophages forming, dense grenz zone, AFB 2-4+, early globi), plus reactional changes on biopsy.

Q8a - Indeterminate Leprosy (5 marks): Earliest leprosy stage, subtle hypopigmented macule with ill-defined borders, minimal sensation change, no nerve enlargement, no granulomas on histology, variable lepromin, 75% spontaneous cure, differential diagnosis, and PB-MDT treatment.

Q8b - M. leprae (5 marks): Fite-Faraco staining, morphological index (MI), inability to culture, armadillo and mouse foot-pad models, 11-14 day doubling time, optimal 27-30°C growth temperature, reductive genome evolution, PGL-1 antigen role, Schwann cell tropism mechanism, respiratory droplet transmission, and 5-year average incubation period.

Q9a - Genital Herpes in Pregnancy (5 marks): Maternal risks by trimester, neonatal transmission rates (primary 26-56% vs. recurrent 2-5%), Whitley classification of neonatal herpes (SEM/CNS/disseminated) with mortality, prevention (serology screening, suppressive acyclovir from 36 weeks), delivery management (cesarean if active lesions), avoidance of fetal scalp electrodes, and neonatal IV acyclovir dosing.

Q9b - Non-Treponemal Tests for Syphilis (5 marks): Cardiolipin antigen basis, reagin antibodies, VDRL (microscopic flocculation, CSF gold standard) and RPR (macroscopic with carbon particles, field-use) tests, TRUST/USR variants, titre interpretation at each stage, prozone phenomenon, and comprehensive list of acute vs. chronic biological false positives (BFP).

Q10a - Diagnosis of C. trachomatis in Men (5 marks): NAAT (gold standard - first-catch urine or urethral swab, 93-96% sensitivity), cell culture (McCoy cells, historical gold standard), DFA, EIA/ELISA, Gram stain for urethritis establishment, serology (MIF for LGV), and first-line treatment (doxycycline 100 mg BD x 7 days).

Q10b - Classification of Balanoposthitis (5 marks): Infective (candidal, anaerobic/bacterial, STI-specific including circinate balanitis of Reiter syndrome), dermatological (Zoon's plasma cell balanitis, BXO/lichen sclerosus, psoriasis, lichen planus, fixed drug eruption, contact dermatitis), premalignant/malignant (erythroplasia of Queyrat, bowenoid papulosis, SCC), and miscellaneous (diabetic, traumatic, non-specific).

This is a shared conversation. Sign in to Orris to start your own chat.